THYROID: Edited by Angela M. LeungThyroid nodules in children and adolescentsBauer, Andrew J. Author Information Division of Endocrinology and Diabetes, The Thyroid Center, Children's Hospital of Philadelphia, Associate Professor of Pediatrics, The Perelman School of Medicine, The University of Pennsylvania, Philadelphia, Pennsylvania, USA Correspondence to Andrew J. Bauer, MD, Division of Endocrinology and Diabetes, 3500 Civic Center Blvd, Buerger Center 12-149, Philadelphia, Pennsylvania 19104, USA. E-mail: [email protected] Current Opinion in Endocrinology & Diabetes and Obesity 26(5):p 266-274, October 2019. | DOI: 10.1097/MED.0000000000000495 Buy Metrics Abstract Purpose of review Compared with adults, there is a two-fold to three-fold increased risk of malignancy for a pediatric patient undergoing evaluation of a thyroid nodule. In 2015, the American Thyroid Association published guidelines on the evaluation and management of pediatric patients with thyroid nodules and differentiated thyroid cancer. The goal of this clinical update is to review recent additions to the literature and propose opportunities how to best incorporate these findings into clinical practice. Recent findings Recent additions to the literature include assessment of ultrasound-based scoring systems to improve selection of patients for fine needle aspiration, defining the pediatric-specific risk of malignancy within The Bethesda System for Reporting Thyroid Cytopathology, and broadening our knowledge of the oncogene landscape that supports incorporation of adjunct oncogene testing to rule-in malignancy of nodules with indeterminate cytology. Summary There have been significant additions to the literature on the evaluation and management of children and adolescents with thyroid nodules since publication of the 2015 American Thyroid Association guidelines. Incorporating these changes into clinical care, within the setting of multidisciplinary, pediatric-specific, regional centers, will maximize ongoing efforts to improve the care of children and adolescents with thyroid nodules. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.